Abstract:
BACKGROUND:Chronic myelogenous leukemia (CML) is an indolent but ultimately fatal disease. Because the natural history of CML varies and quality of life with CML may be excellent until shortly before death, deciding whether and when to pursue unrelated donor bone marrow transplantation is often difficult. OBJECTIVE:To compare early transplantation, delayed transplantation, and no transplantation for patients with chronic-phase CML on the basis of discounted, quality-adjusted life expectancy. DESIGN:A markov model comparing different strategies was constructed. This model considers patient age, quality of life, risk aversion, and the competing risks for CML progression and transplant toxicity. SETTING:Therapeutic decision at the time of diagnosis of CML. PATIENTS:The base case is a 35-year-old patient with intermediate-prognosis CML. Younger and older patients with better and worse prognoses are also evaluated. INTERVENTION:Early transplantation, delayed transplantation, and no transplantation. MEASUREMENTS:Quality-adjusted, discounted life expectancy. RESULTS:For patients with newly diagnosed CML, transplantation within the first year provides the greatest quality-adjusted expected survival, although this benefit decreases with increasing patient age. For a 35-year-old patient with intermediate-prognosis CML, transplantation within the first year results in 53 more discounted, quality-adjusted years of life expectancy than does no transplantation. This finding is robust even with varying baseline assumptions. CONCLUSIONS:These results support the use of early unrelated donor bone marrow transplantation for most patients with CML.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Lee SJ,Kuntz KM,Horowitz MM,McGlave PB,Goldman JM,Sobocinski KA,Hegland J,Kollman C,Parsons SK,Weinstein MC,Weeks JC,Antin JHdoi
10.7326/0003-4819-127-12-199712150-00005subject
Has Abstractpub_date
1997-12-15 00:00:00pages
1080-8issue
12eissn
0003-4819issn
1539-3704journal_volume
127pub_type
杂志文章abstract::Eighty-six patients who required heparin therapy were randomly assigned to receive bovine or porcine heparin. Abnormal concentrations of alanine transaminase and aspartate transaminase developed during treatment in 59.3% and 26.7% of patients, respectively. Patient characteristics that significantly influenced the dev...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-100-5-646
更新日期:1984-05-01 00:00:00
abstract::For years patients hospitalized with viral hepatitis have been placed in two categories of isolation--enteric precautions and blood precautions. This strategy was based on the inability to differentiate between hepatitis A and B and on the assumption that feces and blood from patients with either type might be infecti...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-6-872
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Tumor necrosis factor-alpha is present in arteries in giant cell arteritis. OBJECTIVE:To evaluate the efficacy of infliximab, an anti-tumor necrosis factor-alpha agent, in giant cell arteritis. DESIGN:Randomized, controlled trial. SETTING:22 sites in the United States, the United Kingdom, Belgium, Italy, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-146-9-200705010-00004
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Even with optimal pharmacotherapy, symptomatic heart failure is associated with substantial morbidity and mortality. PURPOSE:To determine the efficacy and safety of cardiac resynchronization therapy in adults with advanced systolic heart failure. DATA SOURCES:The Cochrane Central Register of Controlled Tri...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-5-200409070-00101
更新日期:2004-09-07 00:00:00
abstract::Two cases of patients having calcification within the sella turcica (pituitary stones) have been studied and followed up, one patient for 18 years. A detailed analysis of the radiographic findings and endocrinologic profiles of these two patients is presented. The rarity of bona fide pituitary stones and their benign ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-1-66
更新日期:1975-07-01 00:00:00
abstract:OBJECTIVE:To determine the following: a reference range for serum calcitriol during hypercalcemia in a control group of patients with myeloma in whom calcitriol production is known to be appropriately suppressed; the incidence of elevated serum calcitriol levels in hypercalcemic patients with non-Hodgkin lymphoma accor...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-121-9-199411010-00001
更新日期:1994-11-01 00:00:00
abstract::This paper outlines the clinical, serologic, and immunogenetic differences and similarities of Sjögren's syndrome alone (primary) and Sjögren's syndrome associated with rheumatoid arthritis and systemic lupus erythematosus (secondary). The immunoregulation in Sjögren's syndrome is discussed and the incidence of immune...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-212
更新日期:1980-02-01 00:00:00
abstract::Giant cell tumor of bone is a rare, but well-recognized complication of Paget's disease of bone. In contrast, giant cell reparative granuloma (a benign tumor of the jaws occurring primarily in young adults) has never been described in association with Paget's disease. Five patients had giant cell lesions complicating ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-1-35
更新日期:1983-01-01 00:00:00
abstract:PURPOSE:To examine the cost-effectiveness of test-treatment strategies for patients suspected of having Lyme disease. DATA SOURCES:The medical literature was searched for information on outcomes and costs. Expert opinion was sought for information on utilities. STUDY SELECTION:Articles that described patient populati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-1-199801010-00007
更新日期:1998-01-01 00:00:00
abstract::The diagnostic and therapeutic value of the angiotensin converting enzyme inhibitor teprotide (SQ 20881) was assessed in 18 patients with hypertensive emergencies. Mean blood pressure fell 31 +/- 18 mm Hg in the 10 subjects who responded to 1 mg/kg body weight administered intravenously, whereas it fell 5 +/- 3 mm Hg ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-1-43
更新日期:1979-01-01 00:00:00
abstract:DESCRIPTION:This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/0003-4819-155-3-201108020-00008
更新日期:2011-08-02 00:00:00
abstract::In deciding whether to undertake a dietary program to reduce serum cholesterol levels, a person must consider how much benefit to expect. We developed a model that assumes cholesterol reduction is effective and safe in reducing the risk for death from ischemic heart disease. In the model, we considered asymptomatic ad...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-4-605
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Because psychological approaches are likely to produce sustained benefits without the risk for tolerance or adverse effects associated with pharmacologic approaches, cognitive behavioral therapy for insomnia (CBT-i) is now commonly recommended as first-line treatment for chronic insomnia. PURPOSE:To determi...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M14-2841
更新日期:2015-08-04 00:00:00
abstract:PURPOSE:To assess the data that support the use of coronary angiography and angioplasty after acute myocardial infarction, that identify the risks of these procedures, and that analyze their use and costs. DATA SOURCES:English-language articles published between 1970 and June 1995 identified through a search of the ME...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-126-7-199704010-00007
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:A sensitive and acceptable screening regimen for women at high risk for breast cancer is essential. Contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for diagnosis of breast cancer but has variable specificity. PURPOSE:To summarize the sensitivity, specificity, likelihood ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-148-9-200805060-00007
更新日期:2008-05-06 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the usefulness and safety of hydroxychloroquine in patients with decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. DESIGN:Prospective, randomized, placebo, double-blind 6-month trial. PATIENTS:Thirty-eight patients with noninsulin-dependent diabetes resistant to c...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-112-9-678
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Combining endoscopic therapy and beta-blockers may improve outcomes in patients with cirrhosis and bleeding esophageal varices. PURPOSE:To assess whether a combination of endoscopic and drug therapy prevents overall and variceal rebleeding and improves survival better than either therapy alone. DATA SOURCE...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-149-2-200807150-00007
更新日期:2008-07-15 00:00:00
abstract:BACKGROUND:Two recent double-blind, randomized, controlled trials (RCTs) showed that oral steroids and nonsteroidal anti-inflammatory drugs have similar analgesic effectiveness for management of gout, but the trials had small sample sizes and other methodological limitations. OBJECTIVE:To compare the effectiveness and...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M14-2070
更新日期:2016-04-05 00:00:00
abstract::Neuroblastoma, the second commonest solid tumor in children, is a neoplasm of the peripheral autonomic nervous system that usually occurs before children are 6 years old. Therapy of localized tumor (clinical stage I and II) and of a special form of metastatic tumor (clinical stage IV-S) is usually successful, but trea...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-97-6-873
更新日期:1982-12-01 00:00:00
abstract::Deficiency of fat-soluble vitamins (A,D,E, and K) was evaluated in 15 patients with exocrine pancreatic insufficiency secondary to chronic alcoholic pancreatitis. Mild to moderate steatorrhea was present in all patients despite oral pancreatic enzyme therapy for 27 +/- 4 months (mean +/- SE). Deficiency of a single fa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-4-549
更新日期:1982-10-01 00:00:00
abstract::The microorganisms that regularly infect patients with the acquired immunodeficiency syndrome (AIDS) have become well recognized. Most take advantage of defects in T-lymphocyte function, but others, such as Streptococcus pneumoniae and Haemophilus influenzae, take advantage of B-cell defects. Still others, such as Sta...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-5-738
更新日期:1985-11-01 00:00:00
abstract:Background:The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M16-1536
更新日期:2017-06-20 00:00:00
abstract:Background:Delirium is common in hospitalized patients and is associated with worse outcomes. Antipsychotics are commonly used; however, the associated benefits and harms are unclear. Purpose:To conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Data Sources:P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-1860
更新日期:2019-10-01 00:00:00
abstract::Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, symptom management, and end-of-life care is crucial. This article ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC201803060
更新日期:2018-03-06 00:00:00
abstract:BACKGROUND:Motor vehicle crashes (MVCs) remain a leading cause of injury-related deaths in the United States. Primary seat belt laws allow vehicle occupants to be ticketed solely for not wearing seat belts, and secondary laws allow ticketing only for failure to wear seat belts in the setting of other violations. OBJEC...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-2368
更新日期:2015-08-04 00:00:00
abstract:BACKGROUND:Although viral rebound follows cessation of suppressive antiretroviral therapy in chronic HIV infection, a viremic clinical syndrome has not been described. OBJECTIVE:To describe a retroviral syndrome associated with cessation of effective antiretroviral therapy in chronic HIV infection. DESIGN:Case report...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-6-200009190-00010
更新日期:2000-09-19 00:00:00
abstract::Concierge medical practices, which advertise expanded access to care and individualized attention, collect charges both from insurance companies and directly from their patients. Some bill hundreds of dollars for one-time "executive" physicals, whereas others have patients pay annual retainer fees. Yet, virtually no d...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-152-6-201003160-00009
更新日期:2010-03-16 00:00:00
abstract::We surveyed the faculty, fellows, and residents of a department of medicine to determine the relative importance of each of eight personal characteristics evaluated during the interview of house staff candidates. A booklet containing all possible pairings of the eight characteristics was distributed to 219 participant...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-1-108
更新日期:1982-07-01 00:00:00
abstract:Background:FLU-v is a broad-spectrum influenza vaccine that induces antibodies and cell-mediated immunity. Objective:To compare the safety, immunogenicity, and exploratory efficacy of different formulations and dosing regimens of FLU-v versus placebo. Design:Randomized, double-blind, placebo-controlled, single-center...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M19-0735
更新日期:2020-04-07 00:00:00
abstract:OBJECTIVE:To identify the cause of a hypersensitivity pneumonitis and to determine its pathogenesis. DESIGN:Case study. SETTING:Intensive care unit of a referral hospital. PATIENT:A 51-year-old man with chronic bronchitis who developed a hypersensitivity pneumonitis within 1 month after exposure to minocycline, amox...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-6-476
更新日期:1992-09-15 00:00:00